Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP 9189522 | FL |
NPI | 1003352907 |
---|---|
Provider Name | Mrs. Nancy Marie Smyth |
First Address | Dunedin, FL 34698-6615 |
Second Address | Clearwater, FL 33765-1453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2017 |
Last Update Date | 15/06/2020 |